State of Alaska, Department of Administration, Division of Personnel and Labor Relations

Orientation Forms

Last Updated: November 2013

The following forms are necessary to establish your record in the payroll system. You are required to complete forms no later than 3 days after your appointment date.

After you print and complete the forms, your supervisor or administrative staff should review your forms for completeness and provide you with more information about your own duties, your work unit, and specific information for your department.

Print and use the New Employee Forms Checklist when printing the forms. Keep the forms in the order they are listed for easy reference for yourself and your supervisor.

If you have any questions, please contact the Employee Call Center at 465-3009 or employeecallcenter@alaska.gov.

New Employee Forms Checklist

Form I-9 (Employment Eligibility Verification)(Required)

The Federal Immigration Reform and Control Act of 1986 requires all United States employers to verify and document each new employee's identity and authorization to work in the United States. You must complete the Employment Eligibility Verification form and provide the required documentation no later than the first day of employment. You, as the employee, must complete Section 1 of the form; Section 2 will be completed by your supervisor or department representative.

Form I-9

Form W-4 (Employee Withholding Allowance Certificate) (Required)

This form advises the state of your federal tax withholding status. This designation will determine the amount of taxes to be withheld from your salary. If you are not sure what deductions to take, use the worksheets on page 1 and 2 of the form. You may change your deductions whenever you need to by submitting a new W-4 to Payroll Services.

Form W-4

Employee Affidavit (Required)

Under Alaska Statute, state employees are required to swear (or affirm) an oath of office. This oath must be signed by the employee and witnessed by a department representative (administrative staff or supervisor). The form also provides an area for the employee to designate a person or persons to be notified in the event of serious illness or accident.

Employee Affidavit

Address Authorization/Change Form (Required)

This form provides the employer with the employee's resident mailing address. If the option for direct deposit is not exercised it provides an address for mailing payroll warrants.

Address Authorization / Change Form

Confidentiality of Information Acknowledgment (Required)

In the course of work, employees may be responsible for handling confidential or sensitive information. Steps should be taken to prevent the exposure of this information to individuals without a business need or legal right to know.

Confidentiality of Information Acknowledgement

Payroll Direct Deposit Form

This offer to participate in electronic direct deposit complies with AS 37.25.050 and 2 AAC 15.130. Do not fill out this form if you wish to decline the offer. This optional form authorizes a direct deposit of the payroll warrant to a financial institution of the employee's choice. Processing of this authorization through the state payroll system will require two pay periods to complete. You will need to attach a voided check or savings account deposit slip to the form.

Payroll Direct Deposit Form

Equal Employment Opportunity Survey (Required)

This information will be used in statistical calculations only for federal and state EEO reporting requirements.

Equal Employment Opportunity Survey

Union Notification Form (Required for all except XE & PX Employees)

Your position is most likely governed by one of several unions representing state employees. Your supervisor will tell you which union represents your position. You are required to contact the appropriate union within 10 days. These forms will give you contact information regarding union membership and document your receipt (with your signature) of this information.

Note: There is a separate form to download for ASEA (GGU) members.

Union Notification Form for ASEA (GGU)

Union Notification Form for all other Unions

Ethics Disclosure (Required for Outside Employment)

Per AS 39.52.170 (b), the Executive Ethics Act, employees are required to provide notice of employment or provision of services for compensation outside of the state's employment system. Volunteer service must be reported if there appears to be a conflict of interest with the employee's state job.

If this does not apply, you do not need to submit this form.

Ethics Disclosure Form

Prior Service Verification (Required for those with Prior State Service)

This form will be used to determine the amount of leave you will accrue each pay period. You may receive credit for time previously spent in a qualifying leave accruing position and may accrue leave at a higher rate adjusted for your prior service.

If you have never worked for the State of Alaska previously, you do not need to submit this form.

Prior Service Notification Form

Second Injury Fund Questionnaire (Required)

The purpose of this questionnaire is to preserve the employer's right to obtain Second Injury Fund reimbursement if you suffer a work-related injury in employment. This will be retained in a confidential medical file.

Second Injury Fund Questionnaire

Alcohol and Drug Free Workplace Policy (Required)

This form is to ensure you are aware of the state's policy on drugs and alcohol, both in and outside of the workplace. You are required to read and sign the form, which will be placed in your personnel file.

Alcohol and Drug Free Workplace Acknowledgment Form

Read the State of Alaska Alcohol and Drug Free Workplace Policy (pdf) here.

Statewide Policies (Required)

The following are the State Policies you are required to read. The Statewide Policy Acknowledgment form needs to be printed and signed, acknowledging that you have read these policies.

Statewide Policy Acknowledgement Form

Social Security Form (SSA-1945) (Required)

The Social Security Protection Act of 2004 requires state and local government employers to provide a statement to employees hired January 1, 2005 or later in a job not covered by social security. The statement explains how a pension from that job could affect future social security benefits to which you may become entitled.

Social Security Form

Designation of Beneficiary for Unpaid Compensation (Required)

In the event of an employee's death, this form is used to identify beneficiaries for any unpaid compensation that an employee has earned (pay or leave). The total percentage of all primary beneficiaries must equal 100% and the total percentage of all contingent beneficiaries must also equal 100%. This form also needs to be witnessed by a departmental representative (administrative staff or supervisor).

Designation of Beneficiary for Unpaid Compensation Form

Retirement Beneficiary Designation Form (PERS/TRS) (Required for all Full-time and Part-time Permanent/Probationary employees)

If you are in a Nonpermanent or Intern position you are not eligible for Retirement benefits and do not need to complete this form.

In the event of an employee's death, this form is used to identify beneficiaries for retirement benefits the employee has earned. The total percentage for primary beneficiaries must equal 100% and the total percentage for contingent beneficiaries must also equal 100%. This form also needs to be witnessed by a departmental representative (administrative staff or supervisor).

Print the appropriate form from the list below. To find which plan applies to you, visit the What Retirement Plan Am I In? website or refer to the Retirement Information page of this orientation.

Supplemental Annuity Plan Beneficiary Form (Required)

In the event of an employee's death, this form is used to identify beneficiaries for Supplemental Annuity mandatory benefits that an employee has earned. The total percentage for primary beneficiaries must equal 100% and the total percentage for contingent beneficiaries must also equal 100%.

Supplemental Annuity Plan Beneficiary Form

Basic and Select Life Insurance Enrollment or Change Form (Required)

If you are not eligible for health insurance you do not need to complete this form.

Both Basic and Select Life Insurance are available to most State of Alaska employees. This form is used both to enroll for the benefit and to identify your beneficiaries. The total percentage for primary beneficiaries must equal 100% and the total percentage for contingent beneficiaries must also equal 100%.

Download Basic and Select Life Insurance Enrollment/Change Form

Download Select Life Insurance Worksheet (For Your Information)

Optional Benefits Beneficiary Form

In the event of an employee's death, this form is used to identify beneficiaries for Supplemental Life, Accidental Death and Dismemberment, or Survivor insurance that an employee has elected. The total percentage for primary beneficiaries must equal 100% and the total percentage for contingent beneficiaries must also equal 100%.

Optional Benefits Beneficiary Form

Health Insurance Forms

The following forms are for Health Insurance eligible employees only (Permanent Full-time, Permanent Part-time, Permanent Seasonal, or Full-time Long-term Nonpermanent employees). You must enroll within 30 days of employment to avoid being placed in the default plan.

AlaskaCare Enrollment

You will need to complete online enrollment at the Division of Retirement and Benefit's website if you are in one of the following groups:

  • Supervisory
  • Confidential
  • Correctional Officers
  • AVTEC Teacher's Association
  • TEAME (Mt. Edgecumbe Teachers)
  • Employees not covered by collective bargaining
  • Marine Engineers (MEBA)
  • Unlicensed Vessel Personnel/Inland Boatmen's Union (IBU)

Union Health Trusts

The following employee groups are covered by Union health trusts. Trusts should be contacted for details about enrollment.

General Government Union (GGU)

IMPORTANT: Print the GGU Health Trust Notification Form

The GGU Health Trust Notification Form provides the ASEA Health Benefits Trust with information needed for health insurance enrollment. It is the responsibility of the employee to fax this form to the Trust. (The fax number is on the form.) An information packet with additional forms will be mailed to you directly from the Trust.

For more information go to https://www.aseahealth.org/ or call 866-553-8206

Labor, Trades and Crafts (LTC)

IMPORTANT: Print the LTC Health Trust Notification Form

The LTC Health Trust Notification Form provides the LTC Health Trust with information needed for health insurance enrollment. It is the responsibility of the employee to return this form to the Trust.

Disclaimer: This New Employee Orientation program and forms are developed and maintained by the Department of Administration, Division of Personnel and Labor Relations. State benefit programs, costs, and general employer/employee policies can be affected by changes in state or federal law, state regulation, and/or state benefit programs. The Department of Administration, Division of Personnel and Labor Relations attempts to keep this information current on a regular basis and, in that regard, disclaims responsibility for conveying employer benefit program and cost information or employer policies that may have changed in the interim.